Traumatic Brain Injury

Can medical cannabis help people with this condition? Find out more below. 

What is a Traumatic Brain Injury?

Traumatic Brain Injury (TBI) is a sudden, external force that disrupts the brain’s normal function. This damage can result from a violent blow, a jolt to the head, or an object penetrating the skull. TBI can lead to a range of symptoms depending on the severity of the injury, such as physical, cognitive, and emotional impairments. Symptoms can be mild and temporary or severe and long-lasting, potentially resulting in lifelong disability or death.

What causes it?

Various external factors commonly cause Traumatic Brain Injury. Some leading causes include motor vehicle accidents, falls, sports injuries, physical assaults, and military combat. TBI can also occur due to work-related accidents, particularly in industries that involve heavy machinery or where there is a high risk of falling. In addition, TBI can be caused by non-traumatic events such as lack of oxygen, strokes, or brain infections.

How common is it?

Traumatic Brain Injury is a significant public health concern affecting millions of people worldwide each year. In the United States alone, it is estimated that there are approximately 1.7 million cases of TBI annually, with over 50,000 deaths and more than 280,000 hospitalizations. Moreover, TBI is a leading cause of disability among children and young adults. The true prevalence of TBI may be even higher, as many mild cases may go undiagnosed or unreported.

Are there types/stages?

Traumatic Brain Injury can be categorized into two main types based on severity: mild and moderate to severe. Mild TBI, or a concussion, typically presents with temporary symptoms that resolve within days to weeks. Moderate to severe TBI, on the other hand, can result in more serious and long-lasting impairments. Furthermore, TBI can be classified as either closed or penetrating, depending on whether the skull remains intact or is penetrated by an object.

In terms of stages, TBI recovery is generally divided into three phases: acute, subacute, and chronic. The acute phase occurs immediately after the injury and is characterized by medical stabilization and assessment of the injury’s severity. The subacute phase follows and focuses on rehabilitation, including physical, occupational, and speech therapy. Finally, the chronic phase involves long-term management and support to maximize functional recovery and address any ongoing challenges related to the injury.

Signs & Symptoms

The signs and symptoms of Traumatic Brain Injury can vary depending on the severity of the injury and the area of the brain affected. Symptoms may appear immediately following the injury or develop gradually over hours or days. Common signs and symptoms of mild TBI include headache, dizziness, confusion, nausea, fatigue, blurred vision, ringing in the ears, and brief loss of consciousness. 

More severe cases may present with persistent headaches, repeated vomiting, seizures, slurred speech, weakness or numbness in extremities, and prolonged loss of consciousness. Additionally, TBI can result in cognitive, emotional, and behavioral changes, such as memory problems, difficulty concentrating, mood swings, depression, and irritability.

Diagnosis & Treatment

Diagnosing Traumatic Brain Injury typically begins with a thorough clinical evaluation, including a detailed injury history and a physical examination. The Glasgow Coma Scale (GCS) is a commonly used tool to assess the level of consciousness and neurological function, providing an initial indication of the injury’s severity. Imaging tests, such as computed tomography (CT) scans or magnetic resonance imaging (MRI), may be used to visualize the brain and identify specific areas of damage, bleeding, or swelling.

Treatment for TBI depends on the severity and specific circumstances of the injury. Mild TBI may only require rest, over-the-counter pain relievers, and monitoring of symptoms. In more severe cases, immediate medical intervention is necessary to stabilize the patient, manage intracranial pressure, and address any life-threatening complications. Surgical procedures may be required to repair skull fractures, remove blood clots, or relieve pressure within the skull. Once the acute phase has passed, rehabilitation involving physical, occupational, and speech therapy may be necessary to help the patient regain lost function and learn to cope with any long-term impairments.

Can medical cannabis help?

There is growing interest in the potential of medical marijuana to help manage symptoms and improve outcomes in individuals with Traumatic Brain Injury. Some studies have suggested that the active compounds in marijuana, known as cannabinoids, may have neuroprotective and anti-inflammatory properties that could limit brain damage and promote recovery. In particular, cannabidiol (CBD) has shown promise in reducing inflammation, anxiety, and seizure activity, while tetrahydrocannabinol (THC) may help with pain management and sleep disturbances.

A retrospective study in the American Surgeon aimed to investigate the relationship between marijuana use and outcomes in patients with traumatic brain injury. The researchers analyzed the medical records of 446 adults with TBI who were admitted to a Level-1 trauma center. Among these patients, 82 (18.4%) had a positive toxicology screen for THC, the primary psychoactive component of marijuana. The study found that TBI patients who tested positive for THC had a lower mortality rate than those who tested negative.

Another review article in the British Journal explored the role of endocannabinoids, the body’s naturally occurring cannabinoids, in the context of traumatic brain injury. The authors summarized various studies in animal models that demonstrated the potential neuroprotective effects of endocannabinoids and exogenous cannabinoids, such as THC and CBD, in reducing inflammation, oxidative stress, and cell death following TBI. 

The evidence supporting the use of medical marijuana for TBI is still limited, and more research is needed to establish its safety, efficacy, and optimal dosing. Some studies have shown conflicting results and concerns about potential side effects, such as cognitive impairment, dependence, and increased risk of psychiatric symptoms. As a result, the use of medical marijuana for TBI should be approached with caution, and patients should consult with their healthcare provider before considering this treatment option.